A REVIEW OF ASSISTIVE TECHNOLOGY AVAILABILITY IN NIGERIA: AN ANALYSIS OF UNMET NEEDS, SYSTEMIC BARRIERS, AND PSYCHOSOCIAL-WELLBEING IMPACTS.

Abstract

Background: The provision of prosthetic, orthotic (P&O), and hearing assistive devices in Nigeria represents a critical but severely neglected component of healthcare, rehabilitation, and social inclusion. Despite a high burden of disability, access to these life-changing technologies remains critically low, with profound implications for physical and psychosocial well-being.

Objective: This systematic review synthesizes evidence on the availability, systemic barriers, and psychosocial impact of assistive technologies in Nigeria. It aims to quantify access gaps, analyze the interconnected barriers perpetuating "cycles of scarcity," and propose an integrated, multisectoral framework for systemic reform.

Methods: A systematic review was conducted following PRISMA guidelines. Databases (PubMed, Scopus, Google Scholar, African Journals Online) and semantic search tools were queried for literature from 1981 to 2025. Sixty-one studies meeting inclusion criteria were analyzed through narrative synthesis across pre-defined domains: quantitative access, device types, barriers, service infrastructure, psychosocial outcomes, and proposed solutions.

Results: The synthesis reveals a profound systemic crisis. Only 9-12% of Nigerian amputees access prosthetic devices, with similarly low adoption rates for hearing aids. Access is crippled by a multi-layered barrier system: prohibitive costs, severe geographic maldistribution of services, critical shortages of trained personnel, profound awareness and knowledge gaps, and culturally inappropriate device design. Despite these barriers, robust evidence demonstrates that access to appropriate devices yields significant psychosocial benefits, including higher quality of life scores, reduced odds of depression and anxiety, and enhanced social participation. Indigenous innovations and recent policy developments, such as a N20 billion Foreign Direct Investment for local production, offer pathways for change but are insufficient to meet national need.

Conclusion: Transforming Nigeria's assistive technology sector from a story of scarcity to one of inclusion requires urgent, coordinated action. A foundational step is the development of Nigerian-specific anthropometric and audiometric data to inform contextual device design. This must be coupled with parallel reforms in financing, local manufacturing, workforce development, and the integration of community-based, psychosocially-informed service delivery models. Addressing this crisis is a matter of fundamental healthcare equity, social justice, and economic productivity.

Keywords: prostheses, orthoses, hearing aids, assistive technology, access barriers, Nigeria, low- and middle-income countries, psychosocial well-being, health systems, community-based rehabilitation